Active NPI 1669447298 Individual Practitioner Female Practitioner

Dr. Prathima Vemuru Reddy , MD

Internal Medicine • Wakefield, MA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Prathima Reddy, MD is a certified Internal Medicine practicing in Wakefield, MA. With approximately 42 years of clinical experience since completing medical education in 1984, Dr. Reddy delivers high-quality medical care to the local community at 1 WALTON STREET.

Dr. Reddy is affiliated with Congenial Healthcare Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include injection, denosumab, 1 mg, established patient outpatient office visit, urinalysis, manual test. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1 Walton Street

Wakefield, MA 01880

Telephone 7812469131

Fax 7812469159

Associated Practice Facility / Clinic

🏢 Congenial Healthcare, Llc Facility NPI 1033620372

Medicare Profile & Education

Medical School

Other

Graduation Year

1984

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Wakefield, MA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

42 Yrs +10.5 yrs vs City Avg

City Avg: 31.5 Yrs

State Avg: 29.3 Yrs

Regional Practice Density

4 Specialists

Practicing in Wakefield, MA (7127 Statewide)

Telehealth Adoption Rate

75.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

58.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Reddy (42 Years) 42 Yrs

Wakefield Specialty Average (31.5 Years) 31.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,980	21	$25.48	$25.06
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	613	209	$499.00	$194.64
81002 Urinalysis, manual test	582	198	$20.00	$3.41
36415 Insertion of needle into vein for collection of blood sample	573	200	$25.00	$8.65
93000 Routine ekg using at least 12 leads including interpretation and report	155	131	$86.00	$15.75
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	154	108	$361.00	$138.23
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	128	90	$30.00	$17.34
82270 Stool analysis for blood to screen for colon tumors	110	110	$20.00	$4.29
90662 Influenza vaccine split virus, preservative free	99	99	$101.00	$81.82
G0008 Administration of influenza virus vaccine	97	97	$80.00	$35.30
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	79	47	$110.00	$34.40
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	73	73	$392.00	$141.47
99213 Established patient office or other outpatient visit, typically 15 minutes	71	54	$275.00	$99.28
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	33	21	$87.00	$15.89
G0009 Administration of pneumococcal vaccine	31	31	$80.00	$35.30
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	28	28	$502.00	$290.44
99496 Transitional care management services for problem of high complexity	28	22	$777.00	$307.36
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	14	13	$181.00	$59.09
G0442 Annual alcohol misuse screening, 5 to 15 minutes	11	11	$30.00	$21.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,280	22	$25.00	$23.19
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	595	212	$499.00	$196.00
81002 Urinalysis, manual test	537	203	$20.00	$3.41
36415 Insertion of needle into vein for collection of blood sample	489	202	$25.00	$8.40
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	252	107	$110.00	$34.43
93000 Routine ekg using at least 12 leads including interpretation and report	138	129	$86.00	$16.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	127	90	$361.00	$139.48
G0008 Administration of influenza virus vaccine	100	100	$80.00	$33.84
90662 Influenza vaccine split virus, preservative free	99	99	$101.00	$71.90
82270 Stool analysis for blood to screen for colon tumors	97	97	$20.00	$4.29
99213 Established patient office or other outpatient visit, typically 15 minutes	88	67	$275.00	$95.87
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	41	41	$392.00	$141.83
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	38	22	$87.00	$15.82
99496 Transitional care management services for problem of high complexity	29	21	$777.00	$302.67
94010 Test to measure expiratory airflow and volume	18	17	$125.00	$30.96
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	13	12	$181.00	$58.11
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	12	12	$475.25	$282.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	2,520	25	$25.00	$21.55
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	674	215	$499.00	$203.01
36415 Insertion of needle into vein for collection of blood sample	485	201	$25.00	$2.97
81002 Urinalysis, manual test	480	189	$20.00	$3.44
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	325	114	$110.00	$36.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	146	93	$361.00	$144.62
93000 Routine ekg using at least 12 leads including interpretation and report	107	98	$86.00	$16.39
G0008 Administration of influenza virus vaccine	77	77	$80.00	$33.68
90662 Influenza vaccine split virus, preservative free	72	72	$101.00	$68.54
82270 Stool analysis for blood to screen for colon tumors	58	58	$20.00	$4.33
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	48	48	$392.00	$148.74
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	42	25	$87.00	$16.53
G0444 Annual depression screening, 5 to 15 minutes	35	35	$51.00	$21.66
94010 Test to measure expiratory airflow and volume	33	32	$125.00	$31.87
99496 Transitional care management services for problem of high complexity	29	23	$777.00	$316.48
99213 Established patient office or other outpatient visit, typically 15 minutes	28	27	$275.00	$102.53
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	18	17	$181.00	$60.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,980	22	$25.00	$20.65
81002 Urinalysis, manual test	657	203	$20.00	$3.48
36415 Insertion of needle into vein for collection of blood sample	621	208	$25.00	$3.00
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	528	199	$499.00	$204.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	300	163	$361.00	$146.41
93000 Routine ekg using at least 12 leads including interpretation and report	140	116	$86.00	$17.09
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	127	127	$392.00	$151.10
G0008 Administration of influenza virus vaccine	108	107	$80.00	$19.53
90662 Influenza vaccine split virus, preservative free	102	101	$101.00	$65.18
82270 Stool analysis for blood to screen for colon tumors	72	72	$20.00	$4.38
90832 Psychotherapy, 30 minutes	66	51	$185.00	$84.86
99213 Established patient office or other outpatient visit, typically 15 minutes	62	54	$275.00	$104.18
G0444 Annual depression screening, 5 to 15 minutes	61	61	$51.00	$21.90
94010 Test to measure expiratory airflow and volume	51	51	$125.00	$35.33
99497 Advance care planning, first 30 minutes	49	45	$230.00	$95.00
0013A Adm sarscov2 100mcg/0.5ml3rd	42	42	$120.00	$45.87
99496 Transitional care management services for problem of high complexity	35	28	$777.00	$319.38
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	33	22	$87.00	$16.37
G2212 Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or	24	22	$110.00	$36.84
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	20	18	$181.00	$60.73
G0009 Administration of pneumococcal vaccine	13	13	$80.00	$19.45
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$560.00	$191.04
90670 Pneumococcal vaccine for injection into muscle	11	11	$365.00	$238.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,380	12	$25.00	$19.55
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	662	214	$499.00	$161.41
81002 Urinalysis, manual test	509	200	$20.00	$3.46
36415 Insertion of needle into vein for collection of blood sample	461	201	$25.00	$2.98
80053 Blood test, comprehensive group of blood chemicals	351	179	$50.00	$10.50
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	348	174	$35.00	$7.72
80061 Blood test, lipids (cholesterol and triglycerides)	236	159	$55.00	$13.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	156	100	$361.00	$117.42
99497 Advance care planning, first 30 minutes	115	110	$219.00	$94.23
83036 Hemoglobin A1C level	114	70	$60.00	$9.65
G0008 Administration of influenza virus vaccine	107	106	$80.00	$19.02
82270 Stool analysis for blood to screen for colon tumors	103	103	$20.00	$4.32
93000 Routine ekg using at least 12 leads including interpretation and report	102	96	$86.00	$19.47
90662 Influenza vaccine split virus, preservative free	97	96	$101.00	$60.79
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	92	92	$392.00	$130.15
G0444 Annual depression screening, 5 to 15 minutes	88	88	$50.00	$20.77
94010 Test to measure expiratory airflow and volume	56	55	$121.89	$40.27
90832 Psychotherapy, 30 minutes	37	36	$150.00	$73.73
82043 Urine microalbumin (protein) level	31	31	$25.00	$5.75
99213 Established patient office or other outpatient visit, typically 15 minutes	27	27	$275.00	$77.15
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	22	17	$181.00	$60.18
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	22	12	$87.00	$16.12
99496 Transitional care management services for problem of high complexity	12	12	$777.00	$259.80

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J0897 Injection, denosumab, 1 mg	1,260	12	$25.00	$18.61
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	765	222	$499.00	$161.95
81002 Urinalysis, manual test	571	200	$20.00	$3.41
80053 Blood test, comprehensive group of blood chemicals	456	204	$50.00	$11.51
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	436	197	$35.00	$8.46
36415 Insertion of needle into vein for collection of blood sample	435	196	$25.00	$2.94
80061 Blood test, lipids (cholesterol and triglycerides)	306	188	$55.00	$14.58
83036 Hemoglobin A1C level	161	80	$60.00	$10.57
93000 Routine ekg using at least 12 leads including interpretation and report	153	133	$86.00	$19.39
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	144	89	$361.00	$121.56
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	110	110	$392.00	$130.84
82270 Stool analysis for blood to screen for colon tumors	105	105	$20.00	$4.29
G0008 Administration of influenza virus vaccine	94	91	$80.00	$18.65
99497 Advance care planning, first 30 minutes	90	74	$219.00	$93.54
90662 Influenza vaccine split virus, preservative free	84	81	$101.00	$54.74
G0444 Annual depression screening, 5 to 15 minutes	58	58	$50.00	$20.65
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	40	30	$181.00	$59.92
82043 Urine microalbumin (protein) level	32	32	$25.00	$6.29
G0009 Administration of pneumococcal vaccine	32	32	$80.00	$18.65
90670 Pneumococcal vaccine for injection into muscle	31	31	$462.00	$207.47
94010 Test to measure expiratory airflow and volume	24	23	$125.00	$41.45
99496 Transitional care management services for problem of high complexity	24	22	$777.00	$259.81
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	21	12	$87.00	$19.01
90832 Psychotherapy, 30 minutes	19	18	$150.00	$72.56
94640 Inhalation treatment for airway obstruction or sputum production	17	11	$64.00	$21.61
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	11	11	$560.00	$185.55
G0403 Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report	11	11	$85.00	$19.39

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	620	213	$499.00	$159.88
81002 Urinalysis, manual test	486	200	$20.00	$3.41
80053 Blood test, comprehensive group of blood chemicals	406	203	$50.00	$12.78
85025 Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count	385	197	$35.00	$9.40
80061 Blood test, lipids (cholesterol and triglycerides)	274	182	$55.00	$16.20
36415 Insertion of needle into vein for collection of blood sample	230	136	$25.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	155	103	$361.00	$118.95
93000 Routine ekg using at least 12 leads including interpretation and report	155	134	$86.00	$19.10
83036 Hemoglobin A1C level	146	80	$60.00	$11.75
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	121	121	$392.00	$129.54
82270 Stool analysis for blood to screen for colon tumors	111	111	$20.00	$4.29
G0008 Administration of influenza virus vaccine	99	94	$80.00	$23.21
90662 Influenza vaccine split virus, preservative free	82	79	$101.00	$52.04
G0444 Annual depression screening, 5 to 15 minutes	79	79	$51.14	$20.25
99213 Established patient office or other outpatient visit, typically 15 minutes	73	60	$275.00	$80.81
84443 Blood test, thyroid stimulating hormone (TSH)	73	65	$45.00	$20.33
99354 Prolonged office or other outpatient service first hour	57	43	$332.00	$141.57
90670 Pneumococcal vaccine for injection into muscle	39	39	$462.00	$199.76
G0009 Administration of pneumococcal vaccine	38	38	$80.00	$23.21
82043 Urine microalbumin (protein) level	33	32	$25.00	$7.00
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	30	23	$181.00	$59.81
99497 Advance care planning, first 30 minutes	27	18	$219.00	$91.83
99496 Transitional care management services for problem of high complexity	17	15	$777.00	$257.78

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	620	208	$375.00	$155.91
81002 Urinalysis, manual test	505	211	$18.98	$3.43
36415 Insertion of needle into vein for collection of blood sample	478	208	$25.00	$2.94
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	214	139	$276.40	$116.50
99354 Prolonged office or other outpatient service first hour	150	95	$200.00	$137.47
93000 Routine ekg using at least 12 leads including interpretation and report	144	125	$80.00	$18.72
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	118	118	$275.00	$126.21
G0008 Administration of influenza virus vaccine	103	99	$35.00	$28.66
90662 Influenza vaccine split virus, preservative free	81	79	$50.00	$47.74
82270 Stool analysis for blood to screen for colon tumors	49	49	$20.00	$4.37
99213 Established patient office or other outpatient visit, typically 15 minutes	44	39	$190.00	$79.40
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	29	24	$100.00	$58.71
G0009 Administration of pneumococcal vaccine	26	26	$35.00	$28.66
90670 Pneumococcal vaccine for injection into muscle	23	23	$225.00	$187.31
99495 Transitional care management services for problem of at least moderate complexity	16	14	$340.00	$178.23
99496 Transitional care management services for problem of high complexity	14	13	$450.00	$251.67
94640 Inhalation treatment for airway obstruction or sputum production	14	11	$30.00	$21.41
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	13	13	$50.00	$18.65
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$260.00	$185.10
94010 Test to measure expiratory airflow and volume	12	12	$62.50	$30.43
G0447 Face-to-face behavioral counseling for obesity, 15 minutes	12	11	$30.00	$27.40

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License MA 71487

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

3054420 (MA)

Commercial Insurance / Payer ID Harvard Pilgrim

65035 (MA)

Commercial Insurance / Payer ID Bc/bs

J09157 (MA)

Commercial Insurance / Payer ID Affordable Networks

73308 (MA)

Commercial Insurance / Payer ID United Healthcare

0401419 (MA)

Commercial Insurance / Payer ID Aetna

587634 (MA)

Commercial Insurance / Payer ID Tufts

071487 (MA)

Commercial Insurance / Payer ID Cigna

B10071201 (MA)

Hospital & Practice Group Affiliations

Congenial Healthcare Llc

1 Walton St, Wakefield, MA 018801209

Phone: 7812469113

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active February 05, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location February 05, 2008

Registered at 1 WALTON STREET, WAKEFIELD, MA 01880 (Tel: 7812469131)

📍

Updated Business Mailing Address February 05, 2008

Registered at 33 CHANDLER RD, BOXFORD, MA 019211512 (Tel: 9785611732)

👤

Provider Name / Credentials Updated February 05, 2008

Recorded as PRATHIMA REDDY, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2008

Internal Medicine (License #71487 in MA)

🟢

Initial NPI Registration & Enumeration February 17, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1669447298

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 17, 2006

Last Update: February 05, 2008

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

33 Chandler Rd

Boxford, MA 019211512

Phone: 9785611732

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.